| NPI | 1326403684 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208D00000X General Practice (Licence: FL ME139645) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL acn914) |
| 208D00000X General Practice (Licence: PR 19461) | |
| Enumeration Date | 2015-12-30 |
| Last Update Date | 2022-10-17 |